Patient Participation In Postoperative Care Activities in Patients undergoing Total Knee Replacement Surgery: Multimedia Intervention for Managing patient Experience (MIME)

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The proposed study has as its focus, the important shared role patients can have in determining the outcomes of their healthcare in the context of postoperative recovery after orthopaedic surgery, specifically, total knee replacement (TKR). The research program has two major aims: 1) to test a multimedia intervention to improve patients’ participation in their postoperative care; and 2) to model various patient processes of care and system factors that may impact on patients’ overall experience and satisfaction with hospital care after surgery. A nurse-led, multimedia intervention expected to increase both the capability (through information) and opportunity (through facilitation) of patients to participate in their goals of care will be introduced during the immediate postoperative period after elective TKR surgery. Advances in information technology, hand held devices and multimedia techniques provide innovative ways to embed nurse-led approaches into the processes of care that can facilitate patients’ participation in their care. A cluster randomised, crossover designed study will be implemented in conjunction with mixed-methods data collection and analysis. The setting will be three orthopaedic wards located at a major, private, metropolitan hospital. Patients undergoing primary TKR surgery and able to provide consent will be recruited to the study, patients in the cross over groups will receive usual care as per the TKR pathway. The intervention will be the application of the nurse-led, multimedia goals of care education package designed to be delivered daily to patients at the bedside by nurses in order to improve patient participation during their recovery. Structural equation modeling will be used to analyse relationships between patient participation, patient satisfaction and patient experience. Data collection methods will include patient interviews, naturalistic observations of practice, patient outcome questionnaires and staff focus groups.